Evaluating Screening Guidelines for Disruptive Behavior Problems in Young Children: A Systematic Review of the Accuracy of Parents' Concerns
Notice bibliographique
Résumé
The burden of suffering associated with disruptive behavior disorders (DBDs) is considerable and may influence the health outcomes of affected individuals across the life course. There is consensus that secondary prevention strategies which target early manifestations of DBDs in young children, known as disruptive behaviour problems (DBPs), are effective in facilitating early intervention and minimizing this burden of suffering. One example of such a strategy can be found within a current Canadian Paediatric Society practice guideline, which recommends that parents' concerns be used to inform decisions to screen for DBPs in children following the 24-month well-child visit until the age of 5 years (Charach, Bélanger, McLennan & Nixon, 2018). It is prudent to ensure accurate screening decisions within these visits, in effort to maximize the efficacy of screening for DBPs within such a program. A systematic review was conducted to determine whether parents' concerns can provide primary care practitioners (PCPs) with enough information to justify a decision in favour of, or against, screening for DBPs, as is currently recommended. 6 electronic databases (Medline (Ovid), Embase (Ovid), Central (Ovid), CINAHL (EBSCOHost), PsycINFO (Ovid), and Eric (Ovid) and Scopus) were searched for diagnostic test accuracy studies that elicited parents' concerns about their child's behavioral, social and/or emotional development, and that measured the presence of DBPs in children aged 0-5 years. Studies that reported proportions of true positive, false positive, false negative, and true negative outcomes (or outcomes from which these measures could be generated) were included. Risk of Bias in eligible studies was assessed using the QUADAS-2. Results from included studies were synthesized to produce calibrated estimates of the accuracy of parents' concerns in the form of weighted kappa coefficients (Kraemer, 1992). Just one study (Glascoe, MacLean & Stone, 1991) met all eligibility and exclusion criteria. Results from this study indicated that only moderate agreement (k(1,0) = 0.533, [0.501; 0.564]) could be found between the absence of DBPs and the absence of parents' concerns. Similarly, only fair agreement (k(0,0) = 0.255, [0.238;0.272]) could be found between the presence of DBPs and the presence of parents' concerns. These results provide some limited evidence that neither the presence, nor absence, of parents' concerns can provide enough accurate information to PCPs to justify decisions in favour of/against screening. However, the ability of systematic search methods to retrieve a sufficiently large body of homogeneous data relevant to this review's research objectives was limited and revealed a gap in the literature. Future research that seeks to replicate the methods of Glascoe et al. (1991) may facilitate more robust analyses of the accuracy of parents' concerns in this context.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,045 | 0,247 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,007 |
| Bibliométrie | 0,021 | 0,015 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,004 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».